Left superior intercostal vein opacification

Case contributed by Dr Prashant Gupta

Presentation

non specific cough

Patient Data

Age: 60-65 years old
Gender: Female
Modality: CT

Note the opacified left superior intercostal vein (LSICV)- its position correlates with the aortic "nipple" that is seen on chest X rays.

It is seen to drain into the acccessory hemiazygous to left of midline which in turn drains into the azygous system after crossing the midline.

Case Discussion

Opacification and more importantly dialtion of azygous and accessory systems usually indicates venous obstruction of some kind, in this case there was none.

At times if the contrast density in the LSICV is similar to the aorta its curvilinear course near the arch can mimic a dissection flap- the so called "pseudo dissection".

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Case Information

rID: 17564
Diagnostic certainty: Certain
Case created: 26th Apr 2012
Last edited: 15th Dec 2015
System: Chest
Inclusion in quiz mode: Included

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